Hypertension in Pregnancy Maternal medicine module part 2
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1) Which of the following is used to prevent hypertensive disorders during pregnancy?
Your junior trainee sees a primi woman who is 8 weeks pregnant and demanding aspirin therapy. Which of the following is an indication to start aspirin therapy?
3) Regarding pre-eclampsia in pregnancy, which of the following statement is correct:
Following statements are true regarding risk prediction models for hypertension in pregnancy;
32 weeks pregnant with proteinuria (0.2 g/24 h) and BP of 150/100 mmHg. Booking BP at 12 weeks was 90/60 mmHg and BP at 20 weeks 95/60 mmHg. No urine proteinuria detected antenatally until 32w. Normal fetal growth. Mild peripheral oedema
A 33-year-old primigravida presents at 34 weeks of gestation with raised BP >160/110.There is no proteinuria and SFH is normal. She is admitted to the hospital and started on antihypertensive therapy.
6) What is the most appropriate further management plan?
A woman with chronic hypertension was converted from Lisinopril to methyldopa in a preconception counselling clinic. The pregnancy was uncomplicated and she delivered spontaneously at term. At what stage postnatally should the antihypertensive medication be switched back to Lisinopril?
A 25 yr old woman has been having persistently high BP>150/100 for 3 days following delivery with no biochemical and hematological abnormalities. She has no underlying medical problem and was not on any antihypertensive drugs during the pregnancy. She id breastfeeding.
8) Which is the most appropriate antihypertensive drug that can be prescribed for her?
9) Which is the most appropriate antihypertensive drug that can be prescribed for her?
The first line drug for 39 yr old primi with preeclmpsia and BP 150/93 at 32 weeks of pregnancy
Which of the following statements regarding physiological blood pressure changes in pregnancy is incorrect?
34 weeks pregnant. Worsening hypertension and proteinuria over 4 weeks. Booking BP was 160/100 mmHg with 3 g proteinuria/24 h quantifi ed. Oral labetalol therapy commenced at booking. Now BP 180/100 mmHg and 9 gproteinurea/24hr
13) High risk factors for pre-eclampsia
14) Moderate risk factors for pre-eclampsia are
A 22 yrs old nulliparous woman at 30 weeks of pregnancy with BP 160/105 mm Hg, complaining og upper abdominal discomfort and headache
A 30-year-old woman presents at 34 weeks of gestation in her first pregnancy with a blood pressure of 152/103 (blood pressure at the beginning of pregnancy – 130/60) with significant proteinuria on urinalysis
17) A 40-year-old woman presents at 32 weeks of gestation in her first pregnancy with a blood
pressure of 143/90 mmHg. Blood pressure at the beginning of her pregnancy was 100/60 mmHg. Quantitative testing indicated no proteinuria. She feels well, with no headaches or visual disturbance.
A 35-year-old G4P3 is currently 16 weeks pregnant and has uncomplicated chronic hypertension.
18) What should be the ideal target BP with treatment?
19) Regarding proteinuria assessment in pregnancy, all are true except;
13 weeks pregnant with BP 160/100 mmHg. History of childhood glomerulonephritis. Urine dipstix shows +++ proteinuria. Similar BP recorded at prepregnancy counselling review 6 months earlier.
The first line treatment for 24 yr old asthamatic woman with BP 150/93 at 28 weeks of pregnancy
A 27-year-old woman presents at 28 weeks of gestation in her second pregnancy with a blood pressure of 152/ 105 (blood pressure at the beginning of pregnancy – 132/58), but with no evidence of proteinuria on urinalysis. She is commenced on oral labetalol and is sent home from the triage department to return in a week for a repeat blood pressure monitoring. At this time, she returns and her blood pressure has increased to 167/115 mmHg, with significant proteinuria on urinalysis. She has a frontal headache and describes spots
20 weeks pregnant. Episodic headaches, palpitations, sweating and tremor. Examination shows BP 160/110 mmHg. BP tends to be highly labile.
A 36 yrs old woman on two medications for preeclampsia undergoes vaginal delivery following induction of labour. Which medication should be stopped or changed postnatally<
The most appropriate drug for 34 yrs postnatal breastfeeding woman with persistent high BP of 150/100
Which of the following supplements is recommended to prevent hypertensive disorders in pregnancy?
40 weeks pregnant. Admitted with headache, hypertension 150/105 mmHg and +++proteinuria on urine dipstix. Obstetric ultrasound shows fetal IUGR. At pregnancy booking, her BP was 100/60 mmHg and her urinalysis showed no abnormality
Your score is